John Jackson

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Practice address

127 Tallulah Ave
Jacksonville, FL 32208-4163

Phone

(904) 707-1943

NPI assigned

Oct 30, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1427658160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 TALLULAH AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322084163",
            "telephone_number": "904-707-1943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 TALLULAH AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322084163",
            "telephone_number": "904-707-1943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JOHN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-30",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347E00000X",
            "taxonomy_group": "",
            "desc": "Transportation Broker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Je-Je Jackson
• Jenna Jackson
• Jennifer Rosemary Jackson, MA
• Jerina Jackson
• Jillian Jackson, MSW
• Joshua Eric Jackson, APRN
• Josie Jackson, LMT
• Kandi Jackson, LCSW, CCM
• Karen Jackson
• Karen Crumley Jackson, REGISTERED NURSE

• Personal Care Attendant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Personal Care Attendant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.